Predict | Admission to a Skilled Nursing Facility
Predict SNF admission risk and reduce rehospitalization.
More than five million patients are transferred from hospitals to skilled nursing facilities (SNFs) annually, but unfortunately, SNF admissions frequently presage avoidable rehospitalizations and adverse events. Close to one in five patients are rehospitalized within 30 days of transfer to a SNF, representing billions in healthcare expenditures annually.
BUILT FOR HEALTHCARE
Ingest, normalize, and blend data
from dozens of health data sources.
Electronic Health Records
Unstructured Clinical Notes
e-Prescribing Data
Vital Signs
Remote Monitoring Data
Medical Claims
Rx Claims
ADT Records
Lab Test Results
Care Quality
Social Determinants of Health
Operations & Services
Risk of admission to SNF in the next 12 months
Patient ID
Gender
Age
Risk Score Percentile
714490223
Female
77
92
Impact on risk
Contributing factor
Value
Frailty Percentile
82%
# of Days Since Last PCP Visit
384
# of Units of Durable Medical Equipment (3M)
4
Pct with Severe Housing Cost Burden
25%
AI INFORMS ACTION
Pinpoint high-risk individuals and surface actionable risk factors.
ClosedLoop generates explainable predictions using thousands of auto-generated, clinically relevant contributing factors.
Improve
Improve evaluation of care needs post-discharge and match appropriate environment
Assess
Assess and reduce risk for falls, pneumonia, UTIs, and chronic conditions
Target
Target specialist consultation for follow-ups in select cases
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